Provider Demographics
NPI:1215650767
Name:COMPTON, CHYNNA PAIGE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CHYNNA
Middle Name:PAIGE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:CHYNNA
Other - Middle Name:PAIGE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 MAYO ST
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:MO
Mailing Address - Zip Code:64759-1157
Mailing Address - Country:US
Mailing Address - Phone:417-214-6403
Mailing Address - Fax:
Practice Address - Street 1:304 MAYO ST
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:MO
Practice Address - Zip Code:64759-1157
Practice Address - Country:US
Practice Address - Phone:417-214-6403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOF05220231363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily